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An analysis in the Annals of Emergency Medicine revealed decision support tools in emergency department computerized provider order entry systems were tied to reductions in medication errors, dosage problems and potential adverse drug events.

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Continuing to reimburse hospital-owned facilities at higher levels than freestanding clinics strains the health care system and is not sustainable as consolidation continues, according to a report from the Alvarez & Marsal consulting firm. Medicare reimbursements are 80% higher for routine assessments and management at hospital outpatient facilities than independent clinics.

Medication errors pose particular risks to babies in the NICU, due in part to the number of medications administered to extremely premature infants, and to the complexity of weight-based dosage calculations required for this population. An article in Nursing for Women's Health asserts that smart pump technology can help minimize medication errors in the NICU. Smart pumps are infusion pumps that provide clinical decision support for bedside nurses administering intravenous fluids and medications. The devices can perform complex dosage calculations, and issue "soft" alerts (which can be overridden) and "hard" alerts (which cannot) when the dosage to be administered varies significantly from the pump's computerized medical "library." Collaboration and a well-conceived integration and communication plan are key to the introduction of smart pump technology into the NICU and to achieving full clinician adoption. Read the abstract.

A study in the Journal for Healthcare Quality indicated that temporary staff in emergency departments were twice as likely to commit medication errors that caused harm to patients as staff who were permanently employed. Researchers said the findings may be attributable to the unfamiliarity of temporary staff with systems and policies, or to quality of care at the facilities that employ them. The study examined data from 592 U.S. hospitals.

Nursing experts at a recent meeting discussed the many work complexities that nurses face -- which can be exacerbated by communication failures, poor facility design and complicated policies -- and said the necessary cognitive task management can lead to cognitive overload. Nurse executives should adopt initiatives to regulate distractions and interruptions and create visual warnings, among other ideas, to help nurses handle cognitive tasks and minimize errors, experts said.

Computerized medical records are being recommended to prevent medical errors, but a study of four leading computer programs showed they actually failed to red flag potentially life-threatening drug combinations. Researchers in Scotland tested systems used by about three-quarters of general practitioners and found they failed to detect known prescribing errors, including contraindicated drugs.